The Man Who Couldn’t Stop (4 page)

Juergen Beckmann, the coach, thought he had the solution. A former downhill racer himself, until a high speed crash almost broke his neck, Beckmann knew the mental problems of the glide well. Watching Tauscher practise, he decided to try an unorthodox control technique that he had picked up from research carried out in the 1960s on short-term memory. To keep the thoughts from his idle mind, Beckmann said that day, Tauscher should count backwards. When he started to glide, he should start at 999 and descend in threes. His mind and his thoughts occupied, the theory went, his legs would be more flexible and his run faster. Tauscher was sceptical, but he gave it a go. He disappeared down the mountain, mumbling under his breath ‘999, 996, 993…'

Today, Beckmann works as a sports psychologist at the Technical University of Munich. His research to help athletes perform under pressure is world famous. But it was his work with the German Alpine ski team from 1991 to 1994 that arguably brought the greatest success. As Tauscher started to ski and count backwards, his times improved. Pretty soon, the former world champion was convinced, and Beckmann, emboldened with his apparent success, shared the secret with the rest of the team.

That was when Beckmann began to work closely with Wasmeier, another former world champion, this time of the giant slalom event back in 1985. The skier was widely considered past his best and even Beckmann's mother said her son's work with him was a waste of time. Yet, at the 1994 Winter Olympics in Norway, Markus Wasmeier won two gold medals for Germany – in the giant slalom and the super-giant slalom. Against all expectations, he earned the unlikely title of the greatest German skier of all time and was named the country's sportsman of the year. He then retired, to spend more time with his thoughts.

Beckmann's backwards count was a form of ritual, which is one way to keep unwanted thoughts from the mind. Rituals are common, and not only among skiers. Just as most people have intrusive thoughts, so too about half of the people in the general population surveyed by psychologists will admit they perform odd and meaningless rituals. Some check the cooker is switched off when they know already that it is. They might give in to urges to tap a wall or count silently, or, if they touch somebody on the left shoulder, feel the need to touch them also on the right. These are not superstitions, which are typically a response to an external cue, such as a salute to a magpie. They are compulsions – an irresistible internal urge to act in a way that is irrational. People don't tend to talk about their compulsions either.
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Most people seem able to cope with their day-to-day rituals and compulsions – or at least they do not seek medical help for them. But, like obsessions, for some people their compulsions can cause real difficulties. These problems, and the subsequent calls for help, usually come when obsessions and compulsions start to work in tandem. The combination can produce OCD. Put simply, most people with OCD develop their compulsions as a way to make their intrusive thoughts go away.

The most obvious way to employ a compulsion to drive away an intrusive thought is to use it to answer a question. If the thought that comes to your mind time and time again is about whether you locked the back door or not, then a compulsive and reassuring check on the door should settle the matter. More indirectly, some people use compulsions as a way to stop the thoughts coming in the first place. A 14-year-old girl with obsessive intrusive thoughts that worms would enter her body, for example, avoided the threat by refusing to open her mouth to speak for ten months.

Sometimes the nature of the compulsions seems to bear no relation to the subject of the obsessions at all. People with OCD can be compelled to tap surfaces or count or say secret words to themselves to ‘undo' the imagined consequences of an intrusive thought, for example that their best friend will die. That might sound unhelpful, but then does counting backwards from 999 make someone a technically better skier?

Compulsions can make obsessive thoughts go away, but only for a short while. One of the many cruel ironies of OCD is that the compulsions, the weapon that obsessed people reach for, make the situation worse. Compulsions act in the same way as thought suppression. An intrusive thought silenced with a compulsive act comes back. It comes back hard.

Mental health professionals refer to OCD as a secret disease and a silent epidemic. The number of people who report obsessions and compulsions to doctors is routinely much lower than the studies of their prevalence would suggest. A lot of people with OCD choose to suffer in silence. Their thoughts are their dirty little secret. They believe they are freaks, and their silence has allowed compulsive actions to come to define their condition. Compulsions, a need to wash hands, to check the back door is locked or to turn a light switch on and off a dozen times, are visible in a way that obsessions – dark intrusive thoughts best kept secret – are not. Like the shape of the letter C in OCD, compulsions are open to the world; they offer a handle on the condition. And like the shape of the letter O, obsessions are sealed off.

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While most people recoil from thoughts of unacceptable, distasteful and downright savage behaviour, not everybody does. Some people experience unpleasant thoughts in a different way; they do not find the idea of hurting someone ego-dystonic, it does not clash with their instincts and motivation. Some of these people, unfortunately, go on to act their thoughts out. We know this because some become sexual offenders.

Deviant intrusive sexual thoughts, which shock most who have them, do not seem to trouble such people. As ridiculous as it may seem, part of this is because they believe their crimes cause no harm. Some men who abuse children believe that a child can be interested in sex with an adult; some rapists believe that women enjoy it; some exhibitionists think their actions are harmless and even give pleasure because they do not touch their victims. Yet even people such as these, whose moral compasses are so severely skewed, can be troubled by their thoughts. Even these people have intrusive thoughts that they find unwanted, and in fact can cause them great distress.

Eddie was one of these. Eddie was 32, married with a child, and he was also a persistent exhibitionist. He would drive to a strange town and wait in a park until a woman walked by. Then he would expose himself. He believed his routine – which also involved parking some distance from the scene of his crime − would make it harder for him to be caught. He did it dozens of times. Yet despite the lengths to which Eddie went to avoid detection, afterwards his mind would flood with intrusive, recurrent – and irrational − thoughts that he would be identified. After Eddie exposed himself the first time, he had repeated thoughts that he would be arrested in front of his wife and child, and be named in the local paper as a sex offender. They occupied almost every moment and persisted for nearly a month.

Eddie was not unusual. Psychologists have investigated how intrusive thoughts occur in other sexual offenders, including child molesters and rapists. Frequently, especially at first, these people report persistent and intense thoughts of the consequences if they were caught. And it is not prison that they fear the most. It is humiliation and loss of status. They know full well that, even though they see their behaviours as normal, the rest of society views sexual offenders as monsters. This challenges their view of their place in the world. The thoughts about being caught threaten their own sense of themselves as a good person. They experience them as ego-dystonic. And as such they find them unwanted and intrusive.

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Unwanted thoughts can centre on the most innocuous of situations. Plenty of people, for instance, report intrusive thoughts about the flaws of partners – boyfriends, girlfriends, wives and husbands. Now, nobody is perfect and a little tension is usual in all relationships from time to time, but in recent years psychologists have started to report a bizarre manifestation of obsessive-compulsive symptoms along these lines.

Here's Mike, a 28-year-old married man:

I am constantly preoccupied with my wife's emotional imbalance. She overreacts to every minor conflict or challenge she encounters at work. Every time it happens I think to myself ‘what kind of mother is she going to be' … It really distresses me. I know all of her good qualities and I know she loves me. I know I am overreacting but I just can't let it rest.

And Jennifer, a 25-year-old businesswoman:

 

I can't stop thinking he is a loser and it just won't work. Then I start obsessing about who will provide for me and the children … I love him and I think he will make an excellent father, and when I think about it rationally I don't think it's an issue.

In 2012, scientists in Israel produced a way to probe these symptoms. Called the partner-related obsessive-compulsive symptoms inventory, it asks people in a relationship to agree or disagree with questions such as ‘I feel an uncomfortable urge to compare my partner's physical flaws with those of other men/women' and ‘I am troubled by thoughts about my partner's social skills' and ‘I find it hard to dismiss the thought that my partner is mentally unbalanced.' It's easy to smile, but when such thoughts can't be turned off then the consequences can cause just as much distress as obsessive thoughts of violence and disease.

Jack, aged 40, who had been with his partner for four years, was disturbed by intrusive thoughts about their relationship.

I check whether I feel love or not. Is this the same feeling as the movies? I try to imagine how life would be by her side in the next twenty years. I imagine how it might be with someone else. I fear I will be stuck with these doubts for ever and won't be able to take it anymore.

Is this OCD? Certainly, Jack complains of thoughts that he doesn't want, that recur, cause him distress and force him to seek constant reassurance. But it's hard to see how many people, especially women, would have much sympathy. Does everybody who marries not have similar doubts at some stage? Isn't this just a classic case of a man who fears commitment? If it is OCD, could and should it be fixed?

Psychiatrists are clear: OCD is not simply an exaggerated form of everyday worries. And it is a mistake to think that the apparently trivial subjects of some intrusive and obsessive thoughts mean they cannot bring serious problems. Bira thought only of a mud wall, and the consequences came to dominate her life. Mike, Jack and Jennifer all sought help for their obsessive thoughts about their relationships and the negative impact these thoughts had on their life. Their thoughts caused them persistent distress for several hours each day. That's the OCD.

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There will be some people who, if they have read this far, will have turned each page of this book with a shake of their head. Ideas to hurt children? Urges to drive my car off the road?
I
don't have thoughts like
that
.

That's certainly possible. Even the best conducted surveys that use trained and face-to-face interviewers come up against a stubborn 5 per cent or so of people who deny they have, or ever have had, unwanted intrusive thoughts. Some are probably lying, though psychologists won't say so. There is a different explanation. If you are absolutely certain that you don't have intrusive thoughts then don't feel too smug just yet. Some people do have these thoughts, the urges to commit murder or to torture animals,
but they simply do not recognize and report them as unwanted
. To these people, such thoughts could feel as normal as to ponder what to buy a child for their birthday. There is a name for such individuals: psychopaths.

In 2008, psychologists in Canada published the results of an experiment that aimed to test whether psychopaths would report fewer unwanted intrusive thoughts. Psychopaths are broadly defined as people who behave in a way that breaches social expectations and norms, but who feel no remorse or shame when they do so. They lie, cheat and steal and can inflict great cruelty with no care that others consider what they do is wrong.

In search of psychopaths, the Canadian psychologists quizzed inmates of the Nanaimo Correctional Centre, a medium-security facility on the south shore of Brannen Lake in Vancouver Island, a local beauty spot and one popular with holidaymakers. One prisoner there told them he had thoughts about throwing a baby off a bridge, just to see the reaction of people, and another had an urge to perform his martial arts on someone for no reason. But almost three-quarters of the prisoners questioned said they did not have intrusive thoughts.

Were these convicts who denied intrusive thoughts psychopaths? The scientists asked them to answer a set of 60 questions, designed to probe people for psychopathic traits. It's a self-report version of the so-called psychopath test. Sure enough, those prisoners with the highest scores on this psychopath test were also those who were less likely to report intrusive thoughts. If they experienced the intrusions and the impulses at all, they seemed less troubled by them. They did not find them repugnant, perhaps because they did not find the contents disturbing.

It's possible that the prisoners were not psychopaths, just liars. Perhaps, even under the controlled conditions of an anonymous study, they were reluctant to admit their most bizarre and unwanted thoughts. Maybe they worried their darkest thoughts would be recorded and used against them. As we'll see, they often are.

 

THREE

The mademoiselle and the Rat Man

I do not fear HIV as it is now understood – a fragile and hard-to-catch virus that leads to an infection that is largely managed with drugs, at least by those who can get them. Obsession closed around my thoughts as they were in 1991 and keeps them in that state today. So the HIV I focus on is the disease of the late 1980s, a devastating and life-ending consequence of lack of control, of a moment's thoughtlessness. A threat so severe that in 1986 it demanded the UK government beam into our houses shocking television adverts with crashing gravestones and the catchphrase ‘AIDS: Don't Die of Ignorance'.